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                <div class="title-body-content">AIH EXPENSE DETAIL</div>



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                    <!--HTML for AIH-Expense-Reference-->
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                        <span class="size-span">Reference#:</span>

                        <select class="sel-ref-aih-expense">
                            <option>FCD ACCOUNT NO.10201 000 000 4875</option>

                        </select> 


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                    <!--HTML for AIH-Expense-Date-->
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                        <span class="size-span">Date:</span>
                        <select class=" sel-date">
                            <option>11/11/2000</option>


                        </select>   

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                    <!--HTML for AIH-Expense-From-->
                    <div class="line-form-aih clearfix">
                        <span class="size-span-from">From:</span>
                        <textarea class="aih-expense-textarea-from">
Micheal Darby
Account Number : for SINGAPORE DOLLAR SETTLEMENT
DO048-02325-7
                        </textarea>

                    </div>

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                        <span class="size-span-from">To:</span>
                        <textarea class="aih-expense-textarea-from">
DSB Bank
Bank Code:7171
Branch Code :048
 6 Shenton Way, DBS Building, Singapore
068809
SWIFT:DBSSSGSG 
                        </textarea>

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                        <span class="size-span">Amount:</span>
                        <input type="text" name="aih-expense-amount-number" class="aih-expense-amount-number" value="SGD 4027.21" />
                        <input type="text" name="aih-expense-amount-number" class="aih-expense-amount-char" value="(SGD FOUR THOUSAND TWENTY-SEVEN DOLLAR AND TWENTY ONE CENTS ONLY" />

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                        <span class="size-span-description">Description:</span>
                        <textarea class="aih-expense-textarea-description">
Expenses-Micheal DarBy-11th-12th Aug 2011                    
                        </textarea>

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                        <span class="size-span">Charge Payer:</span>
                        <select class="aih-expense-charge-payer">
                            <option>AIH</option>

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                            AIH Reinsurance Brokers Limited. Level 27 Centrepoint South, The Boulevard, Mid
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